CORE F: SATELLITE - ABSTRACT Little is known about Alzheimer's disease (AD) and related neurodegenerative disease in American Indian (AI) populations. Several studies suggest that the prevalence of AD and related dementias are lower among AI than other populations, but such studies may severely underestimate the burden of AD among AIs due to lack of awareness, under-diagnosis, misdiagnosis, and lack of understanding of cultural issues specific to AIs. As part of a collaborative effort with the University of Washington Alzheimer's Disease Research Center (UW ADRC), the Partnership for Native Health (P4NH) within the Center for Clinical and Epidemiologic Research is establishing a Satellite Core to conduct a pilot project on AD among participants of the Strong Heart Stroke Study (SHSS) in Oklahoma. We will re-examine 100 SHSS participants from Oklahoma with the same cognitive testing and MRI procedures used in SHSS, augmented by new measures of cognitive function. Our specific aims are to: (1) repeat standard tests of cognitive function administered by SHSS in 2009-2013 and document changes over time by age and sex in 100 participants; (2) explore the feasibility and acceptability of expanding the cognitive battery among 30 participants; (3) repeat structural brain MRIs using the same SHSS protocol as in 2009-2013 on all 100 participants; (4) document longitudinal changes in MRI-defined brain structure and their relationship to cognitive decline; (5) obtain biological samples; (6) work with the Outreach, Recruitment, and Education Core to raise awareness of AD and provide relevant education to community members. This Satellite Core offers an unparalleled opportunity to assess AD in a unique sample that is rural, culturally distinctive, and understudied. We will build a strong foundation for future AD research by determining the feasibility of obtaining measures that can be used to construct normative data for clinical diagnosis of AD in AIs. Our efforts will contribute to a more accurate understanding of AD in AI communities, setting the stage for improved detection, treatment, and prevention for this tragically debilitating disease.